April 18-22, 2001
Prague, Czech Republic
IL-2 and Hepatitis: French research group reports IL-2 did not improve HCV or HBV viral load & ALT
Reported by Jules Levin
IL-2 is an immune therapy administered by subcutaneous injection. It can significantly raise CD4s cell counts in individuals with low or high CD4s. It stimulates an immune response and a remaining question to be explored in two large studies including SILCAAT is whether the CD4s are clinically beneficial. Since IL-2 is not easy to administer we need to know if the CD4 increases are truely beneficial. Howver, preliminary data from a number of studies suggest the CD4 increases are beneficial. You can read the most recent reports on this in the NATAP Reports summaries of the 2001 Retrovirus Conference. The IL-2 report was written by David Margolis, MD, University of Texas, Southwestern Medical Center: Immunology - I-2, CD4 changes during STI, CTIs, Chemokins receptors
Preliminary small research studies have suggested IL-2 might affect Hepatitis. Schlaak et al reported from a study of 7 patients that HCV viral load became undetectable after IL-2 was stopped. In a different study Schlaak (n=5) reported ALT normalized in patients with HBV. ACTG 5088 is a small pilot study (n=19) in coinfecter persons with CD4s>400 in which patients will receive IL-2 + Peg IFN with ribavirin. SECOIIA is a study in Europe in which 120 patients who are non-responders to Peg IFN+RBV after 12 weeks will add IL-2 3 MIU twice daily for 5 days every 8 weeks for 48 weeks. In these studies ALT & HCV viral load responses wil be looked at. In the laege SILCAAT study, which explores if IL-2 offers the clinical benefit associated with the CD4 increases it generates, HCV in a subset of coinfected persons will be followed for clinical progression, LFTs, and viral load. EFFECT OF INTERLEUKIN 2 TREATMENT ON HEPATITIS B AND C INFECTIONS This abstract taken from the program book.
V.P Thibault, C. Delaugerre, V. Calvez, D. Costagliola, R. Tubiana, C. Katlama Virology laboratory-CERVI, GH Pitie-Salpetriere
To assess the effect of Interleukin-2 (IL-2) treatment on Hepatitis B (HBV) or Hepatitis C (HCV) infection in HIV coinfected patients.
72 patients were randomized to receive either sc IL-2 in addition to their prior HAART (IL-2 group) or to maintain HAART alone (control). All patients were tested for the presence of HBV or HCV coinfection and viremia were monitored.
Serological prevalence were 9.7% for HBV and 20.8% for HCV, and 3 patients had both HBV and HCV infection. HBV viremia was not detected anymore in only 1 patient infected with HBV and treated with IL-2, whereas in 3 other patients viremia was stable at a median value of 375,000 copies/ml. In the 3 patients infected with HBV and HCV, HCV replication was detected in only 1 patient and none of them had HBV DNA. In HCV infected patients no difference was detected between IL-2 treated patients and the control group (median 7.6 vs. 7.4 and 7.1 vs. 7.3 Log GenEq/ml before and at W24 treatment, respectively). No significant change of the transaminase (ALT) level was seen during IL-2 treatment.
Although IL-2 has been previously reported to decrease HCV viremia level in HIV coinfected patient, we did not find any significant change in any of our patients neither on HCV replication nor on ALT levels. Noteworthy, one HBV infected patient lost HBV-DNA during IL-2 treatment. This study shows that IL-2 has no influence on hepatotropic viruses and does not seem to alter liver pathogenesis.